AAFP Backs Potential Ban of Tobacco Sales in Military Installations

The AAFP recently signed on to a letter(2 page PDF) sent by more than two dozen health care organizations to the Senate Committee on Armed Services that urges Congress to reject the inclusion of language in the National Defense Authorization Act (NDAA) for fiscal year 2015 that would prevent the Department of Defense (DoD) from implementing any new policy limiting, restricting or banning the sale of tobacco products.

The Oct. 24 letter crafted by the Campaign for Tobacco-Free Kids focuses on an amendment(docs.house.gov) to the House-passed version of the NDAA that Rep. Duncan Hunter, R-Calif., introduced. The amendment states the secretary of defense and the secretaries of the individual military departments "may not take any action to implement any new policy that would limit, restrict or ban the sale of any legal consumer product category" in military commissaries and exchanges.

"This very broad language regarding the sale of all legal products appears primarily designed to block policies to reduce tobacco use," the groups observed in their letter.

Defense Department Review of Tobacco Policies

Hunter's amendment comes on the heels of Navy Secretary Ray Mabus introducing the idea of banning tobacco product sales on military bases and ships back in March. Soon thereafter, Defense Secretary Chuck Hagel ordered Pentagon officials to conduct a review of the issue of tobacco use in the military; that review is scheduled to be completed this month.

Story highlights

The AAFP recently signed on to a letter urging the Senate Committee on Armed Services to reject any language in the National Defense Authorization Act (NDAA) that would prevent banning the sale of tobacco products in the military.

The Oct. 24 letter crafted by the Campaign for Tobacco-Free Kids focuses on an amendment to the House version of the NDAA that stated the Department of Defense may not implement any new policy that would limit, restrict or ban the sale of any legal consumer product in military commissaries and exchanges.

In 2011, 24 percent of those serving in the military smoked, compared with 19 percent of civilians, with between 36 percent and 40 percent of smokers in the military having started after joining the armed forces.

The letter states the defense department review will include recommendations for addressing "the very real health, readiness and financial consequences of tobacco use by service members."

"We urge the Senate to reject the House effort to pre-empt this review," the letter adds. "Congress should not limit the ability of DoD to take steps to help tobacco users to quit and to reduce the number of service members who start."

In their letter, the groups point out that tobacco use in the U.S. military is significantly higher than in the civilian population. In 2011, 24 percent of those serving in the military smoked compared to 19 percent of civilians, for example, and between 36 percent and 40 percent of smokers in the military started after joining the armed forces.

A 2013 NIH study(www.ncbi.nlm.nih.gov) suggested that cigarette use might be higher in the military versus the civilian population for a couple of reasons. First, it found that discounts on cigarettes in military installations were as much as 73 percent below prices of comparable brands at the nearest Walmart stores.

It also noted that the "culture of tobacco in the military is likely driven by factors such as the easy accessibility of tobacco products, including distribution systems created to ensure easy access even in theaters of war, liberal work breaks for smokers that are unavailable to nonsmoking troops, socialization at designated smoking areas on military installations, and initiatives between the tobacco industry and military officials to promote tobacco use among troops."

The letter also references the Institute of Medicine (IOM), which suggested that tobacco use in the military undermines combat readiness by reducing physical fitness and endurance, delaying wound healing and increasing work absenteeism. The IOM also reported that it costs the defense department $1.6 billion each year for tobacco-related medical care, increased hospitalization and lost days of work.

The letter concludes by noting that the department has previously taken steps to reduce tobacco use in the military, including creating smoke-free areas and improving access to cessation services, but more needs to be done. "We are pleased DoD is conducting a thorough review of its policy options and urge the Senate to reject the House language that would pre-empt this review and limit DoD's options."

Campaign to End All Retail Tobacco Sales

On Oct. 20, the Campaign for Tobacco-Free Kids also launched a campaign calling on all national retailers to stop selling tobacco products. The centerpiece of the campaign is a new mobile-friendly website, www.ShopTobaccoFree.org,(shoptobaccofree.org) that offers an interactive map that pinpoints the locations of tobacco-free retailers across the country.

The website currently features more than 20 retail chains with more than 13,000 separate store locations. These include CVS Health, which recently became the first national pharmacy chain to end tobacco sales at all of its stores. Other tobacco-free retailers range from major corporations such as Target and Wegmans to independently owned stores.

"Far too many retailers today are a major part of the tobacco problem in our country and are practically billboards for the tobacco industry," said Matthew Myers, president of the Campaign for Tobacco-Free Kids, in a news release.(www.tobaccofreekids.org) "By ending tobacco sales, retailers can become part of the solution and help make the next generation tobacco-free. Responsible retailers should not be in the business of selling products that kill so many people and endanger the health of our children."